Biomedical subjects
Sam M Wiseman
Publications and source records attributed to Sam M Wiseman.
Current concepts in the management of a second malignancy of the lung in patients with head and neck cancer.
Simultaneous, synchronous, and metachronous presentation of lung malignancies when treating head and neck squamous cell cancers is one of the most difficult challenges in head and neck surgery. However, good (> 40%) 5-year survival can be obtained when proper screening techniques, patient selection, and therapy are combined. Because of the complexity of the head and neck resection and reconstruction and the multiple surgical and medical services used to diagnose and treat this clinical entity, a comprehensive review of the current literature is provided. The clinically pertinent meanings of simultaneous, synchronous, and metachronous second malignancy of the lung are presented. A review of the current literature is presented that divides second lung malignancy into two groups: second primary and metastasis. The incidence of a second lung malignancy is identified. The tools used in the screening of high-risk patients and the role of the new diagnostic studies such as positron emission tomography and positron emission tomography CT scans are reviewed. Finally, the current literature on patient selection and surgical therapy is used to put forth a clinical pathway followed at the authors' institution for the treatment of these patients.
Squamous cell carcinoma of the head and neck in nonsmokers and nondrinkers: an analysis of clinicopathologic characteristics and treatment outcomes.
BACKGROUND: The objective of this study was to describe the clinicopathologic manifestations of disease and outcomes of treatment among individuals without a history of smoking tobacco or consuming alcohol who develop head and neck cancer. METHODS: Of 1648 invasive head and neck cancer cases treated between 1970 and 2001 at Roswell Park Cancer Institute, 40 patients were identified as never having smoked tobacco or consumed alcohol during their lifetime. These cases were reviewed to gather data on multiple clinicopathologic variables. RESULTS: Mean age at presentation of nonsmoker/nondrinker head and neck cancer patients was 60 years (range, 27 to 90 years), and 78% (n = 31) of the patients were women. The distributions of tumor sites were 75.0% oral cavity (n = 30), 20.0% oropharynx (n = 8), and 5.0% larynx (n = 2). Sixteen patients (40%) experienced a recurrence of disease during the follow-up period, and 10 patients (25.0%) developed a second primary tumor a median of 6 years after their initial diagnosis. CONCLUSIONS: The nonsmoker/nondrinker head and neck cancer patient tends to be elderly and female, have oral cavity primary tumors, and be predisposed to second primary tumor development.
Sentinel lymph node biopsy in staging of differentiated thyroid cancer: a critical review.
Sentinel lymph node biopsy has recently been utilized to map tumor lymphatics in patients with differentiated thyroid carcinoma. Currently, controversy centers around the feasibility and future role of this technique in the management of differentiated thyroid cancer patients. A review of the current literature in which sentinel lymph node biopsy was performed on patients with a diagnosis of differentiated thyroid cancer was undertaken. Sentinel lymph node biopsy has been carried out on thyroid cancer patients utilizing a vital dye technique, a radiotracer technique, and a combination of both techniques. In the current literature the average rate of sentinel node identification is 91% (range 66-100%) and when identified, the sentinel node accurately predicts the disease status of the neck in most patients (range 80-100%). Limitations to carrying out the sentinel node biopsy on thyroid cancer patients include staining of parathyroid glands, identification of lymph nodes draining into the mediastinum, and the 'shine through' effect. Sentinel lymph node biopsy is technically feasible, but for a disease in which nodal metastases are of debatable prognostic value, the clinical utility of sentinel lymph node biopsy in the management of patients with differentiated thyroid cancer appears less than promising.
Sentinel lymph node biopsy in SCC of the head and neck: a major advance in staging the N0 neck.
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Adenoid cystic carcinoma of the paranasal sinuses or nasal cavity: a 40-year review of 35 cases.
We retrospectively reviewed 35 cases of adenoid cystic carcinoma that had originated in the minor salivary glands of the paranasal sinuses or nasal cavity. All patients had been seen at two tertiary-care referral centers in western New York State between 1960 and 2000. Twenty patients had been treated with surgery and adjuvant radiotherapy, 10 patients with surgery alone, three with radiotherapy alone, and two with concurrent radiotherapy and chemotherapy. During the study, 22 patients developed recurrent disease--11 locally; three distantly; seven locally and distantly; and one locally, regionally, and distantly. At the conclusion of the study, 14 patients were alive and disease-free, and eight were alive with disease; 10 patients had died with disease, and three had died of other causes with no evidence of disease. Adenoid cystic carcinoma of the paranasal sinuses or nasal cavity is an aggressive neoplasm that results in a high incidence of both local recurrence and distant metastasis, regardless of treatment modality. Most cases are ultimately fatal, although long disease-free intervals have been observed. A combination of surgery and radiotherapy offers these patients the best chance for disease control.